Vascular end-to-side anastomosis

Suitable for the end of the blood vessel to be anastomosed. Treatment of diseases: vascular injury, hand vascular injury, limb vascular injury Indication 1. The outer diameters of the two blood vessels differ too much, exceeding 1/2 of the outer diameter, and the cut ends are still not able to be sutured at the end. 2. The receiving blood vessel is the only blood supply artery in the receiving area, which will cause limb ischemia or necrosis after cutting. Preoperative preparation 1. The blood supply to the blood vessel must be normal. The outer diameter should be similar to that of the receiving blood vessel. It should not be too different and should be of sufficient length. 2. After the supply of the vascular resection, it should cause blood circulation disorder (ischemia or blood stasis) in the donor area. 3. In general, arterial defects were reconstructed with arterial grafts and venous defects were reconstructed with vein grafts. However, clinical practice accounts for a small number of arteries, and a small number of arteries, and some arteries will cause insufficient blood supply in some areas. On the contrary, the location of the vein is superficial, the number is large, and it is easy to find. The superficial vein is removed for a period of time, and it does not cause reflux disorder. Therefore, in microsurgery, autologous vein grafts are often used to repair venous and arterial defects. 4. The autologous veins for transplantation include saphenous vein, small saphenous vein, external jugular vein, cephalic vein, expensive vein, dorsal vein and dorsal vein. The main saphenous vein, small saphenous vein and external jugular vein are too large, which is not suitable for the repair of small vessel defects. Generally, these vein branches are used. These vein branches have appropriate outer diameters and thin walls. They are the same as the superficial veins of the upper limbs, the back of the feet, and the dorsal veins of the hands. They are commonly used for autologous vein grafts. Surgical procedure First cut the end of the anastomosis into a 45-60 degree oblique section. On the vessel that receives the anastomosis, remove the loose tissue from which the anastomosis is prepared. Pull up the wall with a needle or suture, and cut it into a window with a sharp cut, the same size as the end of the blood vessel to be fitted. At the obtuse end of the blood vessel, corresponding to 3 o'clock, the first needle was sutured by a horizontal squat method. At the acute end of the blood vessel, corresponding to 9 o'clock, the second needle was sutured by the horizontal squat method. Equivalent to 6 o'clock, suture the second needle with a horizontal squat method. Equivalent to 6 o'clock, use the horizontal method to sew the third needle. Then stitch the fourth and fifth stitches between 3 and 6 o'clock, 6 and 9 o'clock. The blood vessel was turned 90 degrees, and the sixth needle was sutured at a 12-point position using a horizontal squat method. After rinsing the lumen, sew the seventh needle between 12 and 3 o'clock and sew the eighth needle between 9 and 12 o'clock. Relax the hemostatic clip and check for anastomotic and blood leaks. When the venous end-to-side anastomosis, the shear slope of the vascular end is opposite to the artery. First, the first needle was sutured at 9 o'clock on the left side, and the second needle was sutured at the 3 o'clock position on the right side. complication Pseudoaneurysm or arteriovenous fistula.

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